| NPI | 1750441077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 231975) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN610613) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2025-02-24 |