| NPI | 1346296175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NY 334630) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 33334630) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-07-08 |