| NPI | 1750952412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1107769) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX 772790) |
| 163W00000X Registered Nurse (Licence: TX 958785) | |
| 163WE0003X Registered Nurse, Emergency (Licence: TX 958785) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX 1107769) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 1107769) | |
| 363LC1500X Nurse Practitioner, Community Health (Licence: TX 1107769) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX 1107769) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX 1107769) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1107769) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1107769) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1107769) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1107769) | |
| Enumeration Date | 2021-07-05 |
| Last Update Date | 2024-01-04 |