| NPI | 1417263328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F307489-1) |
| Additional Taxonomies | 163WS0200X Registered Nurse School (Licence: NY 573342) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NY F307489-1) | |
| 364SA2200X Clinical Nurse Specialist Adult Health (Licence: NY F307489-1) | |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2016-07-19 |