| NPI | 1619939501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28195266A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 120711-6) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 4677) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-05-18 |