| NPI | 1114339025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 102937) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR16213100) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN597575) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-07-02 |