| NPI | 1386965606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 083889-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0036757) |
| 163W00000X Registered Nurse (Licence: NJ 26RN12887200) | |
| 163W00000X Registered Nurse (Licence: PA RN559299) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00302300) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2020-12-07 |