| NPI | 1801818299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 100311) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10002852) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-02-07 |