| NPI | 1891832754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28171194A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 1067516) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-10-13 |