NPI | 1306288444 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP124049) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 690658) |
Enumeration Date | 2013-07-17 |
Last Update Date | 2018-10-08 |