| NPI | 1881945590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA RN734278 NA4364) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9311444) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2021-12-30 |