| NPI | 1093235251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ15025400) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN697095) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 112129) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-06-04 |