| NPI | 1538890058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 1102472) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 348013) |
| 174H00000X Health Educator | |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2023-09-05 |