| NPI | 1083710172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 9481) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 0000009481) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2024-01-17 |