| NPI | 1316298672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2297982) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 082440) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2024-01-26 |