| NPI | 1760405641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 334458) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9431779) |
| 163WP0000X Registered Nurse, Pain Management (Licence: NY 334458) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-10-19 |