| NPI | 1396595989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NY 654416) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: NY 654416) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-03-25 |