| NPI | 1851539670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60423412) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 518241) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2024-09-25 |