| NPI | 1457529281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60619663) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 059206-23) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RNA36666) | |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2022-09-14 |