NPI | 1699217547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP132573) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX AP132573) |
Enumeration Date | 2016-11-09 |
Last Update Date | 2024-10-03 |