| NPI | 1295511814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1141160) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: TX 787936) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-11-07 |