| NPI | 1275996878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346408) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NY 592770) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2020-10-26 |