| NPI | 1447356142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 1569842) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 049475-23-11) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-11-29 |