| NPI | 1265661656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 14442) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 146017) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2025-05-12 |