| NPI | 1265468813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-042922) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3017668) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2024-10-19 |