| NPI | 1720804925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: TX 771585) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TX 771585) |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |