| NPI | 1417236134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1023) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101173) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2023-07-05 |