| NPI | 1225721582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A10942) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ14910200) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2025-08-21 |