| NPI | 1851835862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01210400) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 623530) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2023-07-13 |