| NPI | 1356315170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SD 0598) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R42766) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2023-12-28 |