| NPI | 1255114039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: NY 893776) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 893776) |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2024-06-25 |