| NPI | 1134717283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 25994) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 131944) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2023041151) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7048) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1008897) | |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2024-01-18 |