| NPI | 1992258750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP08918) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA AP08918) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2019-08-29 |