| NPI | 1275029530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 793427) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9348972) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2023-03-16 |