| NPI | 1609992783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA457A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA457) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-12-30 |