| NPI | 1588071211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN631189) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L1-0041054) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2022-07-21 |