| 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 |