| NPI | 1639139819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN230546) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R186467) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 230546) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2024-04-24 |