| NPI | 1154780104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SC0200X Clinical Nurse Specialist Critical Care Medicine (Licence: TX AP117019) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: TX 700044) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-19 |