| NPI | 1174978076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN647888) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209-022942) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 694128-1) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R231334) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-05-01 |