| NPI | 1588610323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 043168) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 3254) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-03-16 |