| NPI | 1992448088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: IL 209.025570) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: IL 209.025570) |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2025-11-06 |