NPI | 1811454051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 686773) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 431879) |
Enumeration Date | 2019-02-25 |
Last Update Date | 2025-03-12 |