| NPI | 1194463273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN695448) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 136969) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2025-06-02 |