| NPI | 1437589470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 564146-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR13866100) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NR138666100) | |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2025-09-12 |