| NPI | 1487089173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00553700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NO12099700) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN622578) | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2023-12-01 |