NPI | 1922641299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 73051) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP143635) |
363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP143635) | |
Enumeration Date | 2019-10-19 |
Last Update Date | 2023-04-21 |