| NPI | 1568711851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000494) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN95086086) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 33 336713) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 702312) | |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2020-06-24 |