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 |