| NPI | 1699485227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01401400) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001877) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2022-12-05 |