| NPI | 1992805535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 000275) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 090463-23) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2023-03-01 |