| 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 |