| NPI | 1598301657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN293987) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR R106754) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2022-09-26 |