| NPI | 1548376437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN00396) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 206366) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-08-01 |