NPI | 1093711780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NR08622100) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN501475L) |
Enumeration Date | 2005-06-27 |
Last Update Date | 2019-04-17 |