| NPI | 1598634586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1195332) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX 1195332) |
| Enumeration Date | 2025-10-30 |
| Last Update Date | 2026-01-20 |