| NPI | 1043983810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28302214A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024182621) |
| 163W00000X Registered Nurse (Licence: NC 307968) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6832) | |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2026-06-08 |