| NPI | 1942561030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 242685) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN01007) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2024-12-16 |