| NPI | 1750450789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R147404) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L1-0034916) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2018-12-18 |