| NPI | 1982598629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 38909) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 155471) |
| Enumeration Date | 2025-06-06 |
| Last Update Date | 2025-07-24 |