| NPI | 1457993016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP143496) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP143496) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71012895A) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IN 71012895A) | |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: IN 71012895A) | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2023-10-30 |