| NPI | 1154836781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 62391) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901470) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 898852) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024183480) | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2023-10-30 |