| NPI | 1124624523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 25708) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 9639147-3102) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA RN95076697) | |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2024-02-14 |