| NPI | 1346794187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00680700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR17227800) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2024-10-15 |