| NPI | 1427626514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN619305) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 619305) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-07-13 |