| NPI | 1134137284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA APO3822) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 2761) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2023-03-29 |