| NPI | 1891161303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ14973600) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP130422) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 25-570-881) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2023-12-14 |