| NPI | 1023587144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 9524) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: FL RN9296154) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024177358) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11007010) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 766713) | |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2022-01-11 |