| NPI | 1346675477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D137634) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IA 100831) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN602869) | |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2021-12-20 |