| NPI | 1457524001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-102653) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 27931) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2023-08-04 |