| NPI | 1639170434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA MD480367) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0051753) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2024-03-21 |