| NPI | 1104062223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SH0200X Clinical Nurse Specialist, Home Health (Licence: TX 009581) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: TX 009581) |
| 374U00000X Home Health Aide (Licence: TX 009581) | |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2008-12-18 |