| NPI | 1427020353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 11251) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN118353) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 810498) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2024-04-14 |