| NPI | 1871767558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA3684) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3684) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2021-12-01 |