| NPI | 1376514893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0431) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200060018crna) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2025-05-08 |