| NPI | 1881101749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN652426) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 120584) |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2023-08-24 |