| NPI | 1881696839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN304233L) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM R40292) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2024-10-21 |