| NPI | 1467521211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3004533) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 39624) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2024-01-11 |