| NPI | 1063712974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9373571) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020502) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L1-0032184) | |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2022-05-24 |