| NPI | 1689832891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NY 585404-01) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: NY 585404-1) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2009-09-08 |