| NPI | 1598147811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: TX 255690) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: TX 2556790) |
| 247000000X Technician, Health Information (Licence: TX 2355690) | |
| 251K00000X Public Health or Welfare | |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |