| NPI | 1568098655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01040700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26nr19255000) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 728906) | |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2022-11-15 |