| NPI | 1841763786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 27458) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 22506) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2020-10-23 |