| NPI | 1417453358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WI0600X Registered Nurse Infection Control (Licence: NJ 26NR17447600) |
| Additional Taxonomies | 163WH0200X Registered Nurse Home Health (Licence: NY 691840) |
| 163W00000X Registered Nurse (Licence: NY 691840) | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2023-06-05 |