| NPI | 1811926371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 750225) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN054802) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2018-07-20 |