| NPI | 1245271949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT NUR-APRN-LIC-197289) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-080705) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2024-01-17 |