| NPI | 1447080478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 819696) |
| Additional Taxonomies | 163WS0200X Registered Nurse School (Licence: NY 819696) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |