| NPI | 1760404354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R28727) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 540) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2024-11-08 |