| NPI | 1396502738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 720961) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 720961-01) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-06-11 |