| NPI | 1295728020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7035) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN102466) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2023-08-23 |