| NPI | 1568354793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 786578) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR24964100) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |