| NPI | 1609241538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA GA-CRNA001081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001231147) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0003966-C-CRNA) | |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2022-11-14 |