| NPI | 1457245219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: TX 1180460) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: CA 95298195) |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2025-06-05 |