| NPI | 1861544173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3005108) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 006495) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28214783A) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2021-08-20 |