NPI | 1952774523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP129160) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP129160) |
Enumeration Date | 2015-11-04 |
Last Update Date | 2023-07-24 |