| NPI | 1669471827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28230243A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 127107) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2025-06-17 |