| NPI | 1487395422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN696313) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 137239) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-10-11 |