| NPI | 1477360816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA2000X Registered Nurse, Administrator (Licence: TX 1165909) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: TX 1165909) |
| Enumeration Date | 2024-12-17 |
| Last Update Date | 2024-12-17 |