| NPI | 1265218184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 907467) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 907467) |
| 163WH0200X Registered Nurse, Home Health (Licence: TX 907467) | |
| 163WC3500X Registered Nurse, Cardiac Rehabilitation (Licence: TX 907467) | |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-06 |