| NPI | 1578929451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN784106) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN196238) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD ac003518) | |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2024-03-13 |