| NPI | 1932872249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 137514) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 107076) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 137514) | |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2024-11-14 |