| NPI | 1003625955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: TX 023742) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: TX 023742) |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |