| NPI | 1043010374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NJ 26nr24446100) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-05-02 |