| NPI | 1891487245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 1075261) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT127406) |
| 163WW0000X Registered Nurse, Wound Care (Licence: TX 1075261) | |
| 163WH0200X Registered Nurse, Home Health (Licence: TX 1075261) | |
| 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: TX 1075261) | |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-05-24 |