NPI | 1689067902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP127669) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP127669) |
Enumeration Date | 2015-03-11 |
Last Update Date | 2015-06-05 |