| NPI | 1316531908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 221350) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 25007) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2023-11-13 |