| NPI | 1841838166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 136527) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: PA RN683944) |
| 207L00000X Anesthesiology (Licence: FL APRN11026455) | |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2023-10-17 |