| NPI | 1578794483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 14478) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 122581) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 810575) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2023-11-30 |