| NPI | 1598080541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R230515) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168740) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2024-03-13 |