| NPI | 1053323170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201909433CRNA-PP) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201403680CRNA) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2023-02-21 |