| NPI | 1508402397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 25265) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28258077A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 265546827) | |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2022-10-11 |