| NPI | 1346809456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 743979) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 743979-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2022-09-14 |