| NPI | 1831798354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 258404) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN pending) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2021-06-24 |