| NPI | 1699324236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11027325) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 172894) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2024-09-20 |