| NPI | 1427782481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01377600) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: PA RN717617) |
| 163WE0003X Registered Nurse, Emergency (Licence: NJ 26NR18738300) | |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-10-05 |