| NPI | 1063650976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN00282) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA00047-G) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA36690) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2023-03-16 |