| NPI | 1679408587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: NY 788590) |
| Additional Taxonomies | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: NY 788590) |
| Enumeration Date | 2026-06-15 |
| Last Update Date | 2026-06-15 |