| NPI | 1538400973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0993822) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 680095) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9270689) | |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2020-11-04 |