| NPI | 1447921713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX 1058633) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX R0481) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1058633) | |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2023-11-30 |