| NPI | 1568269744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 824553) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TX 824553) |
| 163WH0200X Registered Nurse, Home Health (Licence: TX 824553) | |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 824553) | |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-08-28 |