| NPI | 1144373705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NJ 26NJ00128900) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NJ 26no111105) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-10-01 |