| NPI | 1215331327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 692806) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 692806) |
| 163W00000X Registered Nurse (Licence: PA 654959) | |
| 163W00000X Registered Nurse (Licence: NJ 26NR16012600) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |