| NPI | 1386151231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F349475) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NY 723925) |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2023-01-27 |