| NPI | 1316927924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 259431) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R869287) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9316235) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-07-02 |