| NPI | 1114249299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: TX 742099) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 742099) |
| 163WC1500X Registered Nurse, Community Health (Licence: NJ 26NR11805800) | |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |