| NPI | 1538125182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN270741-L) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: PA RN270741L) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2022-08-05 |