| NPI | 1659434710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28178299A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN168455) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 168455) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2018-06-27 |