| NPI | 1487690723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 2899) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 153388) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-07-16 |