| NPI | 1457874604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01182100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 636871) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 636871) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2024-04-26 |