| NPI | 1447767561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00830900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR18366700) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2019-05-07 |