| NPI | 1841023546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 727874) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95279275) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |