| NPI | 1295353712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01389600) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR16229100) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 73279301) | |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2022-11-01 |