| NPI | 1144964008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 688252-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 688252-01) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-05-12 |