| NPI | 1003672346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ15034400) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 147728) |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2025-01-14 |