| NPI | 1033670245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: TX AP141365) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: TX 833654) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2019-04-13 |