NPI | 1437457249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139907) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 048005-23) |
363LA2100X Nurse Practitioner, Acute Care (Licence: VT 101-0091635) | |
Enumeration Date | 2011-03-02 |
Last Update Date | 2023-02-10 |