| NPI | 1447508353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NJ 26NR24797100) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 309236) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2023-09-12 |