| NPI | 1649031782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1138260) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: TX 353569) |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |