| NPI | 1952637563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00282100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 524513-1) |
| 163W00000X Registered Nurse (Licence: NJ 26NR12777100) | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2013-04-04 |