| NPI | 1437853470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NJ 26NJ01461200) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NJ 26NJ01461200) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ01461200) | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2025-10-01 |