| NPI | 1548517519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00396400) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN603677) |
| 227900000X Respiratory Therapist, Registered (Licence: NJ 43ZA00452100) | |
| 163W00000X Registered Nurse (Licence: NJ 26NR12577100) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2015-02-24 |