| NPI | 1427479633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11031248) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH COA.15483-NA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704425680) | |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2025-10-14 |