| NPI | 1265923825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 078251-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN677235) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200840629RN) | |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2018-07-16 |