| NPI | 1144917733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN728205) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 142824) |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2026-06-30 |