| NPI | 1710923271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-039206) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 134236) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2019-09-09 |