| NPI | 1578812855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52218) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| 376J00000X Homemaker | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2024-04-03 |