| NPI | 1477526481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP06330) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN094021) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 10415) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-05-09 |