| NPI | 1568884096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 2599441) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 765794) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0000720-C-CRNA) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NM APRN-CRNA-54037) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MT APRN-196442) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201903465-CRNA) | |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2022-09-14 |