| NPI | 1760358808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 921428) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: NY 921428) |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-21 |