| NPI | 1750707766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-0A00774) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 608266) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 625010) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2023-08-18 |