| NPI | 1093783789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 507850) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY F430629) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2015-08-07 |