| NPI | 1700065752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00258700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 26NO11335800) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NO11335800) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2024-09-11 |