| NPI | 1295186260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 21308) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1165937) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TN 21308) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 21308) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1165937) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-07-31 |