| NPI | 1689105462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28140469A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R103479) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003183) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2018-03-09 |