NPI | 1578360699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 7947701-8900) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: UT 7947701-3102) |
Enumeration Date | 2025-02-26 |
Last Update Date | 2025-04-09 |