| NPI | 1215436951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2273527) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: RI RN55502) |
| 163W00000X Registered Nurse (Licence: NH 080964-21) | |
| 163W00000X Registered Nurse (Licence: CT 111555) | |
| 163W00000X Registered Nurse (Licence: MA RN2273527) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 080964-23) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 7588) | |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2023-05-19 |