| NPI | 1518036243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 1513) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 082497) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2024-12-03 |