| NPI | 1891291845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: TX AP136199) |
| Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural (Licence: TX AP136199) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |