| NPI | 1912441916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ01068400) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 111104) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN630412) | |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2024-04-25 |