| NPI | 1801267505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 537012-1) |
| Additional Taxonomies | 163WG0100X Registered Nurse Gastroenterology (Licence: NY 537012-1) |
| 163WP0000X Registered Nurse Pain Management (Licence: NY 537012-1) | |
| 163WS0121X Registered Nurse Plastic Surgery (Licence: NY 537012-1) | |
| 163WU0100X Registered Nurse Urology (Licence: NY 537012-1) | |
| 163WX0800X Registered Nurse Orthopedic (Licence: NY 537012-1) | |
| 163WX1100X Registered Nurse Ophthalmic (Licence: NY 537012-1) | |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |