| NPI | 1851697494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00318700) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95006309) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NJ 26NJ00318700) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NY F430556) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000705) | |
| Enumeration Date | 2011-01-30 |
| Last Update Date | 2018-03-17 |