| NPI | 1346552437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 782357) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP119191) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2022-06-21 |