| NPI | 1538129101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00268700) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP109830) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP109830) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2025-02-11 |