| NPI | 1053644971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10019146) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0085602) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL arnp 9323666) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2025-06-02 |