| NPI | 1861280281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN771569) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR23761800) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ15345300) | |
| Enumeration Date | 2025-04-26 |
| Last Update Date | 2025-07-22 |