| NPI | 1477060242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP09700) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP134492) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 23883) | |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2024-05-15 |