| NPI | 1225290844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 25335) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R853108) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-10-14 |