| NPI | 1407538945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NJ 26NR17655200) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NJ 26NR22717700) |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-03 |