| NPI | 1770091027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TX AP133925) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: TX AP133925) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |