| NPI | 1588129886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 34667) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 090873-23) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11002597) | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2023-11-29 |