| NPI | 1497245716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00849000) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 122086) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR18328900) | |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2021-11-01 |