| NPI | 1487756177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NJ 26no12263100) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: NJ 43za00316600) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-07-08 |