| NPI | 1598862120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3004381) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4381A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28172150A) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2023-07-31 |