| NPI | 1851741581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2264525) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2264525) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 090586-23) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2023-07-24 |