| NPI | 1386672582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 3372) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 54308) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2024-06-25 |