| NPI | 1275973588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00835700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 841640) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4412) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2024-04-26 |