| NPI | 1548710098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00720000) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 604353) |
| Enumeration Date | 2016-10-08 |
| Last Update Date | 2024-12-02 |