NPI | 1932685773 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 123658) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 620794) |
Enumeration Date | 2018-07-16 |
Last Update Date | 2022-03-26 |