| NPI | 1962558064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-871A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28130758A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 811028) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-10-02 |