| NPI | 1629440938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209019505) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2018) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0992033-CRNA) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP129705) | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2022-09-29 |