| NPI | 1366493488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 300934) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC R76080) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2024-03-08 |