| NPI | 1851433023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000440) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 720780) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2025-08-04 |