| NPI | 1437653706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 311926) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 311926) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-07-17 |