| NPI | 1881080489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 613606-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 613606) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-09-21 |