| NPI | 1629841374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: TX 1014736) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1014736) |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2024-07-12 |