| NPI | 1235184342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN223523) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA36580) |
| 207L00000X Anesthesiology (Licence: MA RN223523) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VT 101-0034868) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-12-27 |