| NPI | 1073532032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA APRN-CRNA123295) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN.APRN18085) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC RN192749) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2025-12-02 |