| NPI | 1598307522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP142626) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP142626) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP142626) | |
| 163WN0300X Registered Nurse, Nephrology (Licence: TX AP142626) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP142626) | |
| 163WH0500X Registered Nurse, Hemodialysis (Licence: TX AP142626) | |
| 163WD1100X Registered Nurse, Dialysis, Peritoneal (Licence: TX AP142626) | |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2026-04-13 |