| NPI | 1134860406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101691) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 101691) |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2022-05-09 |