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 |