| NPI | 1427249093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 5036356-4406) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA695) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2020-06-04 |