| NPI | 1164536801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01369) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NR1159100) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 622779) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-01-30 |