| NPI | 1578636122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 659439) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 659439) |
| 363L00000X Nurse Practitioner (Licence: LA AP04261) | |
| 208M00000X Hospitalist (Licence: TX 659439) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-09-19 |