| NPI | 1508026675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60451883) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0015035-CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168700) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2024-05-06 |