NPI | 1275332918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 0001290486) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001290486) |
363L00000X Nurse Practitioner (Licence: TX 1200930) | |
363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX 1200930) | |
Enumeration Date | 2025-03-12 |
Last Update Date | 2025-06-05 |