NPI | 1992770556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LG-0012103) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN296984L) |
363L00000X Nurse Practitioner (Licence: PA VP003845B) | |
Enumeration Date | 2006-02-17 |
Last Update Date | 2023-01-16 |