| NPI | 1528484888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000121) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 748907) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2024-09-24 |