| NPI | 1427343771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 292613-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 668095) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2023-09-10 |