| NPI | 1578718516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 832383) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 69377) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN780404) | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2023-11-22 |