| NPI | 1851525877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP06586) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CTP000096) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2023-04-19 |