| NPI | 1447821178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R217743) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: MD R217743) |
| Enumeration Date | 2021-07-04 |
| Last Update Date | 2024-03-09 |