| NPI | 1134915846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WI0500X Registered Nurse, Infusion Therapy (Licence: NY 970291-01) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NY 970291-01) |
| Enumeration Date | 2025-04-18 |
| Last Update Date | 2025-04-18 |