| NPI | 1487914149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11007664) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-097572) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11007664) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 89841) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 18838) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-097572) | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2023-04-21 |