| NPI | 1497781140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00341600) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26N011136700) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 5116a) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-10-19 |