| NPI | 1144751371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 240244) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 6970) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2021-12-22 |