| NPI | 1487767000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 23950) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN081047 AP03809) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2024-07-30 |