| NPI | 1508003427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 3797) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 080538) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2021-12-28 |