| NPI | 1609446145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 26577) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-145380) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001586) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2022-09-22 |