| NPI | 1801526025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 752258) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R253362) |
| 163W00000X Registered Nurse (Licence: DC RN1062583) | |
| Enumeration Date | 2022-06-11 |
| Last Update Date | 2022-06-11 |