An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
TX license #D8646taxonomy 174400000X
Identifiers
Type
Value
Notes
05 (TX)
0352775-01
01
1871561308
INDIVIDUAL NPI
Practice context
Multi-provider organization.
2 individual providers on file at this primary address.
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