| NPI | 1992278766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 763032) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 124464) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1070772) | |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2024-07-02 |