| NPI | 1538198734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024167314) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC 1002703) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2023-07-19 |