| NPI | 1447490289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP117811) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX AP117811) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2026-04-14 |