NPI | 1982384129 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 34307) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024187654) |
363L00000X Nurse Practitioner (Licence: TN 34307) | |
363LF0000X Nurse Practitioner Family (Licence: VA 0024187654) | |
Enumeration Date | 2023-07-21 |
Last Update Date | 2024-10-09 |