| NPI | 1467984666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP133689) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 918326) |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX AP133689) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-08-23 |