| NPI | 1801806849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: TX AP114689) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: TX RN625942) |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP114689) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-06-28 |