| NPI | 1447511225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003017) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 16696) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-11-29 |