| NPI | 1497864615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28220828A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4770A) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-11-27 |