| NPI | 1336289933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NH 086980-23) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: FL ARNP 9221480) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-173285) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9221480) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-11-12 |