NPI | 1952816159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: NY 728277) |
Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: NY 728277) |
163WR0400X Registered Nurse, Rehabilitation (Licence: NY 728277) | |
Enumeration Date | 2017-12-10 |
Last Update Date | 2017-12-10 |