| NPI | 1497376461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP145398) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX AP145398) |
| 207RH0000X Internal Medicine, Hematology (Licence: TX AP145398) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP145398) | |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2024-03-01 |