| NPI | 1598226359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP138140) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX AP138140) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-04-05 |