| NPI | 1003225541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: TX 823233) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: TX 823233) |
| 376K00000X Nurse's Aide (Licence: TX 823233) | |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2014-08-08 |