| NPI | 1750779591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28242030A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 19504) |
| Enumeration Date | 2015-01-01 |
| Last Update Date | 2018-10-24 |