| NPI | 1912961723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26N010983200) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN352802L) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 649073) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2013-04-12 |