| NPI | 1073750873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NY 609984) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR14011900) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |