| NPI | 1285593699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 1002317) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: TX 1002317) |
| 163WE0003X Registered Nurse, Emergency (Licence: TX 1002317) | |
| 376G00000X Nursing Home Administrator (Licence: TX 11694) | |
| Enumeration Date | 2026-01-21 |
| Last Update Date | 2026-01-21 |