| NPI | 1326858705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WI0500X Registered Nurse Infusion Therapy (Licence: NY 895226-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 895226-01) |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |