| NPI | 1861434458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: TX 631560) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 196491) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2008-01-03 |