| NPI | 1225029846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN185936) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: GA RN185936) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-11-14 |