| NPI | 1356652887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WH0200X Registered Nurse Home Health (Licence: NY 5609851) |
| Additional Taxonomies | 163WS0200X Registered Nurse School (Licence: NY 5609851) |
| 163WH0500X Registered Nurse Hemodialysis (Licence: NY 5609851) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2012-08-02 |