| NPI | 1588933303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: TX 014655) |
| Additional Taxonomies | 251E00000X Home Health (Licence: TX 014655) |
| 251F00000X Home Infusion (Licence: TX 014655) | |
| 251J00000X Nursing Care (Licence: TX 014655) | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2019-09-12 |