| NPI | 1437451135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP119749) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 706203) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2021-12-03 |