| NPI | 1740759406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: TX 018448) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 742930) |
| 163WA2000X Registered Nurse, Administrator (Licence: TX 018448) | |
| Enumeration Date | 2018-11-24 |
| Last Update Date | 2018-11-24 |