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) |
363LF0000X Nurse Practitioner, Family (Licence: NY 346408) | |
Enumeration Date | 2016-03-31 |
Last Update Date | 2025-08-19 |