NPI | 1134669302 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 341430) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 605113) |
Enumeration Date | 2017-03-07 |
Last Update Date | 2023-11-27 |