| NPI | 1265585616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: TX 750029) |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health (Licence: WI 138020-030) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: WI 138020-030) | |
| 163WH0200X Registered Nurse Home Health (Licence: TX 750029) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2009-03-01 |