| NPI | 1053185256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: NJ 26NJ15000900) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR22665200) |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2024-04-10 |