| NPI | 1821549379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD r191185) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD R191185) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2024-04-19 |