| NPI | 1275319063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX 1129518) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1129518) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 892148) | |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-20 |