NPI | 1528432135 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP129572) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP129572) |
Enumeration Date | 2015-11-19 |
Last Update Date | 2022-02-10 |