| NPI | 1043211832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP109111) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024161198) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH NA04692) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3370282) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN336267-L) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 55673) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2022-07-29 |