| NPI | 1366709297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28243275A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169993) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3007328) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 15838) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2025-09-30 |