| NPI | 1629519293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 814036) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 814036) |
| 163WF0300X Registered Nurse, Flight (Licence: TX 814036) | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |