| NPI | 1952366577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5866) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 308475) |
| 363L00000X Nurse Practitioner (Licence: NJ 26NJ00175000) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ NR11819500) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2022-09-22 |