| NPI | 1427596113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN201641) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 28490) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2024-04-15 |