| NPI | 1386980233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 544995) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 544995-1) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2022-01-03 |