| NPI | 1841504446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 013078) |
| Additional Taxonomies | 163WH1000X Registered Nurse, Hospice (Licence: TX 013078) |
| 164W00000X Licensed Practical Nurse (Licence: TX 013078) | |
| 374U00000X Home Health Aide (Licence: TX 013078) | |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2010-08-06 |