| NPI | 1497432330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 708705-01) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 708705) |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2026-06-17 |