| NPI | 1447733274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 29690) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RN60978) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2022-03-17 |