| NPI | 1477880110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00276300) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NR12165200) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN573735) | |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2024-07-23 |