| NPI | 1740021385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: NY 625906) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 625906) |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2024-06-06 |