NPI | 1922035765 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP112695) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 658745) |
363LA2100X Nurse Practitioner, Acute Care (Licence: TX 658745) | |
Enumeration Date | 2006-06-27 |
Last Update Date | 2016-04-20 |