| NPI | 1447394606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168443) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 3100) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2024-10-02 |