| NPI | 1609340827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 31642) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 120222) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2022-11-21 |