| NPI | 1841127461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: NY 522320) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 522320) |
| Enumeration Date | 2026-05-07 |
| Last Update Date | 2026-05-07 |