NPI | 1760151369 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 160603) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 160603) |
Enumeration Date | 2021-09-08 |
Last Update Date | 2021-10-19 |