| NPI | 1518403617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-148906) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 087836-23) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901421) | |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2023-02-28 |