| NPI | 1770685281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 089000547CRNA) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: OR 089000547CRNA) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2024-12-07 |