| NPI | 1528337375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28270719A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704255424) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2025-11-03 |