| NPI | 1487046199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R53341) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R876982) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2024-04-16 |