| NPI | 1982346938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 087605-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 159739) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2022-07-28 |