NPI | 1295011641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: TX 699234) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 699234) |
Enumeration Date | 2011-10-31 |
Last Update Date | 2023-09-23 |