| NPI | 1538576657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0106X Nurse Practitioner Occupational Health (Licence: TX AP125605) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NV APRN002952) |
| 363LX0106X Nurse Practitioner Occupational Health (Licence: NV APRN002952) | |
| 163W00000X Registered Nurse (Licence: NV RN99248) | |
| 163WE0003X Registered Nurse Emergency (Licence: TX 762810) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2022-08-10 |