| NPI | 1821381278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 120159) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 810497) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2025-03-03 |