| NPI | 1366399883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NY 723984) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NY 723984) |
| 163WH0200X Registered Nurse, Home Health (Licence: NY 723984) | |
| 163WN1003X Registered Nurse, Nutrition Support (Licence: NY 723984) | |
| 163WW0000X Registered Nurse, Wound Care (Licence: NY 723984) | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: NY 723984) | |
| 163WA2000X Registered Nurse, Administrator (Licence: NY 723984) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 723984) | |
| 163WC1500X Registered Nurse, Community Health (Licence: NY 723984) | |
| Enumeration Date | 2026-03-13 |
| Last Update Date | 2026-03-13 |