| NPI | 1447909304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01331800) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 686170) |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2023-10-03 |