| NPI | 1255881447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00947400) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00947400) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR15494000) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2025-03-05 |