| NPI | 1417152331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 256994) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 256994) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2023-07-07 |