| NPI | 1134581846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 818566) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901376) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-12-20 |