| NPI | 1396422879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 738364) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 738364) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2026-03-12 |