| NPI | 1487698213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28158807A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: IN 28158807A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209004938) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-10-09 |