| NPI | 1356058606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 841870-01) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 841870) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA RN720771) | |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2023-02-09 |