| NPI | 1033211131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 173) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 0105995) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 086274-23) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2024-07-29 |