| NPI | 1407959380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-902A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 625990) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-04-29 |