NPI | 1023394152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP125776) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 4451) |
363LA2100X Nurse Practitioner, Acute Care (Licence: MO AP125776) | |
Enumeration Date | 2011-11-03 |
Last Update Date | 2022-10-13 |