| NPI | 1295149235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 70000525-8901) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9303569) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60506972) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2023-04-12 |