NPI | 1184142184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021245) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 21245) |
Enumeration Date | 2017-08-30 |
Last Update Date | 2023-06-29 |