NPI | 1629135538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00222400) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NJ002224000) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2017-01-07 |