| NPI | 1235452038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U6282) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 839966) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R184418) | |
| 207P00000X Emergency Medicine (Licence: TX 725736) | |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2024-01-22 |