| NPI | 1588426860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 149811) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI RN53962) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-04-08 |