| NPI | 1992138424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R179771) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 235447) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2023-10-18 |