| NPI | 1417319518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NY 309269) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 309269) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-07-07 |