| NPI | 1326286220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9412584) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 27329) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D120456) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2010027852) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2023-05-08 |