| NPI | 1609171412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 085805) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28247395A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 15530) | |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2021-07-27 |