| NPI | 1285797266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 481026-1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 481026) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2022-09-12 |