| NPI | 1881353449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NJ 26NJ01219900) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NJ 26NR18275200) |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2023-12-02 |