| NPI | 1245724301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ15024300) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN590397) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NR18057100) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2024-11-11 |