NPI | 1437541331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127306) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 257185) |
Enumeration Date | 2015-03-02 |
Last Update Date | 2015-07-16 |