| NPI | 1659674760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 663310) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX 663310) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2016-09-20 |