| NPI | 1457302663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN356833L) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 3978) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 084174-23) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-09-07 |