| NPI | 1366281859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 940946) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 940946) |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2024-06-01 |