| NPI | 1417446956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 311095) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 311095) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2023-07-07 |