| NPI | 1194672410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NY 881731-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 881731-01) |
| 163WC0400X Registered Nurse, Case Management (Licence: NY 881731-01) | |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: NY 881731-01) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: NY 881731-01) | |
| Enumeration Date | 2026-03-16 |
| Last Update Date | 2026-03-16 |