| NPI | 1396379525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP145332) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H158450) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP145332) | |
| 163W00000X Registered Nurse (Licence: CA 95155222) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NE 91079) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 844664) | |
| 363L00000X Nurse Practitioner (Licence: NE 113125) | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2024-10-23 |