Individual
ASEFA GULTU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4513 W PIONEER DR APT 620, IRVING, TX 75061-3821
(469) 360-4638
Mailing address
4513 W PIONEER DR APT 620, IRVING, TX 75061-3821
(469) 360-4638
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
942366
TX
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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