| NPI | 1740249184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY F432324) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9216546) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 462471-1) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 462471) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-06-06 |