| NPI | 1659604072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 434) |
| Additional Taxonomies | 372500000X Chore Provider (Licence: NY 434848) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2009-09-17 |