| NPI | 1053346593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID N-31082) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY 50101) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2023-05-26 |