| NPI | 1679767602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: NY 408844-1) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 408844-1) |
| Enumeration Date | 2007-09-03 |
| Last Update Date | 2007-09-03 |