| NPI | 1417216599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: TX 010809) |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based (Licence: TX 010809) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2024-03-08 |