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Individual
MR. MICHAEL AYDALLA
Active
Individual
MR. MICHAEL AYDALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC, MSN, RN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1045274
TX
363LA2100X
Acute Care Nurse Practitioner
1045274
TX
363LA2200X
Adult Health Nurse Practitioner
1045274
TX
363LG0600X
Gerontology Nurse Practitioner
1045274
TX
Other
Enumeration date
07/16/2021
Last updated
04/03/2023
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