| NPI | 1134159783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN247392L) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 52578) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-03-26 |