| NPI | 1033556691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002971) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CTP-000240) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2023-08-02 |