| NPI | 1932516044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC001430) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0033444) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 26NR14385400) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-12-05 |