| NPI | 1518946730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN182928) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 1-088207) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2023-10-10 |