| NPI | 1457113318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN727899) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R234267) |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2025-04-07 |