| NPI | 1316909542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM 66362) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 05257623) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA2416) | |
| 363L00000X Nurse Practitioner (Licence: NH 05257623) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2023-09-20 |