| NPI | 1881443018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TX 1046208) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: TX 748267) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |