| NPI | 1003332982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 309466) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020133) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11019675) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704297223) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2024-11-01 |