| NPI | 1457973547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX AP145633) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP145633) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP145633) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 909089) | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-01-16 |