| NPI | 1316505894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00934500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 26NR19055100) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2023-02-02 |