| NPI | 1023286408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 557409) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 557409) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2023-08-04 |