| NPI | 1699726158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R851130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS R851130) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-11-13 |