| NPI | 1366438756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA22316) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN00809) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2022-11-01 |