| NPI | 1598570558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1190611) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 975567) |
| Enumeration Date | 2025-02-07 |
| Last Update Date | 2026-02-19 |