| NPI | 1265962955 |
|---|---|
| Former Name | PHILLIP ROSS WHITE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 874375) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 328868) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-06-21 |