| NPI | 1316306723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC002240) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 76057) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2022-10-24 |