| NPI | 1447254834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 051581) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 126850) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2025-04-02 |