| NPI | 1952801243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP136751) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 793546) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP136751) | |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2023-11-09 |