| NPI | 1336975507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 1032896) |
| Additional Taxonomies | 163WC3500X Registered Nurse, Cardiac Rehabilitation (Licence: TX 1032896) |
| 163WG0000X Registered Nurse, General Practice (Licence: TX 1032896) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: TX 1032896) | |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2024-09-12 |