| NPI | 1417479015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 814041) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 175930) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2024-12-19 |