| NPI | 1225357676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2010015107) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003084) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2024-05-01 |