| NPI | 1851397699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00282500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR09989700) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN322809L) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2024-08-21 |