| NPI | 1427242098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141263) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: TX 101895) |
| 163W00000X Registered Nurse (Licence: TX 799100) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2019-04-10 |