| NPI | 1356120711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 585252) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NY 585252) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 585252) | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |