| NPI | 1881638427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 740515) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 03425) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-07-12 |