| NPI | 1467503235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169045) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 482750) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ14993700) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2025-06-10 |