| NPI | 1114364486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SM0705X Clinical Nurse Specialist Medical-Surgical (Licence: TX 500143) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist Family Health (Licence: TX 500143) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |