| NPI | 1417189283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 602483-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 602483) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 113757) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2016-11-23 |