NPI | 1144001611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1138829) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 886999) |
Enumeration Date | 2023-10-11 |
Last Update Date | 2025-03-14 |