| NPI | 1093999021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP125701) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NJ 26NR12004300) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN583285) | |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NY 558308-1) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 583285) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 854745) | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2024-04-16 |