| NPI | 1265743421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA 232358) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS A810351) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-11-20 |