| NPI | 1588951321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 575242) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT 157824) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 575242) | |
| 163W00000X Registered Nurse (Licence: NY 575242) | |
| 163WE0003X Registered Nurse, Emergency (Licence: NY 575242) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-05-02 |