| NPI | 1548284417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01116500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR20441600) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704195077) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 391867-1) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2025-09-25 |