| NPI | 1982948295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 796464) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NV APN001451) |
| 363L00000X Nurse Practitioner (Licence: NV APRN001451) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61332499) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NV APN001451) | |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2025-03-31 |