NPI | 1144851494 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP144733) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 842476) |
Enumeration Date | 2020-01-27 |
Last Update Date | 2024-09-17 |