| NPI | 1346809456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA253057) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 743979) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 743979-1) | |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2025-10-06 |