NPI | 1992540835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 936324) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR25823400) |
Enumeration Date | 2024-07-01 |
Last Update Date | 2024-07-01 |