| NPI | 1730472796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01489) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ RN152361) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2023-02-01 |