| NPI | 1851462253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R085399) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 85399) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2025-01-29 |