| NPI | 1891779732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN174475) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 062441-23) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-01-04 |