| NPI | 1396278164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9397808) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL RN9397808) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-02-09 |