| NPI | 1982640348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA 209552) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: RI APRN01300) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-10-02 |