| NPI | 1346260577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 715) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 188870) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-02-14 |