| NPI | 1255219168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: TX 981319) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: TX 981319) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 981319) | |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: TX 981319) | |
| 163W00000X Registered Nurse (Licence: TX 981319) | |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2026-06-16 |