| NPI | 1346288800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024164968) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0001176758) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2024-05-16 |