| NPI | 1053390187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 0004960-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 276825) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 176117) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-02-29 |