| NPI | 1396892329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 233) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 072142) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2023-02-17 |