NPI | 1932086386 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1195224) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1195224) |
363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX 1195224) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1195224) | |
Enumeration Date | 2025-08-18 |
Last Update Date | 2025-08-18 |