| NPI | 1326746207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 718454) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 290457) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ15025600) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-032664) | |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2025-11-06 |