| NPI | 1740228956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN768704) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 074055) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-03-28 |