| NPI | 1841477163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN164337) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 28637) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2024-06-14 |