| NPI | 1801338769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28232032A) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28232032A) | 
| Enumeration Date | 2016-11-09 | 
| Last Update Date | 2024-03-11 |