| NPI | 1417205097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 670277) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4398) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: DE APN-0001678) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN577637) | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2025-08-04 |