| NPI | 1467770743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R192160) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR12109300) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00308100) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2011-01-29 |