| NPI | 1548265093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C001373) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C01373) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2024-02-01 |