| NPI | 1184320343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101744) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 901804) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-02-24 |