| NPI | 1649220583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN10000289) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024188439) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 484280) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP3253332) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 4006657) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-04-23 |