NPI | 1467086967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX AP145199) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP145199) |
Enumeration Date | 2020-02-24 |
Last Update Date | 2021-08-26 |