| NPI | 1407214224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ14870500) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 164262) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 20984) | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2023-08-17 |