| NPI | 1649742263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R186915) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R186915) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 730014) | |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2019-10-01 |