| NPI | 1841491206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 124326) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 124326) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-02-21 |