| NPI | 1346815693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: TX 1045488) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: TX 872347) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-09-02 |