| NPI | 1568841831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 623088-1) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 623088) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2016-01-05 |