| NPI | 1326284076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 294411) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 80411) |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2023-09-29 |