| NPI | 1447876693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD 127527) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD R227360) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2026-05-12 |