| NPI | 1194591370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 873067) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9555748) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ15247000) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11031253) | |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2025-04-05 |