| NPI | 1134657745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 908446) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: LA RN124357) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2017-05-25 |