| NPI | 1316319379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 700515) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN651410) |
| 163W00000X Registered Nurse (Licence: OH RN.410503) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 575773) | |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-12-28 |