NPI | 1588304968 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 808778-01) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2352141) |
Enumeration Date | 2022-03-31 |
Last Update Date | 2025-06-26 |