| NPI | 1366439176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11013552) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201403006CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 664195) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201907877CRNA-PP) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2022-12-27 |