| NPI | 1235147687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C01523) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9280085) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-09-30 |