| NPI | 1841772225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00929900) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 618454) |
| Enumeration Date | 2018-09-03 |
| Last Update Date | 2019-06-26 |