| NPI | 1679915235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2361341) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L1-0040469) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC001842) | |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2022-03-14 |