| NPI | 1386956654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist Family Health (Licence: NY F336516-1) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: NY 596466-1) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2016-08-23 |