| NPI | 1861956518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003269) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR c003269) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2022-10-21 |