| NPI | 1376541722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 4072) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 123746) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN10192) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 123746) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 6045A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN605111) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 77137) | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2011-04-27 |