| NPI | 1861584005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN00008) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 241092) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-07-24 |