| NPI | 1316178148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 3407) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 208334) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2024-07-12 |