| NPI | 1659626836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 075486-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9300639) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2343379) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2021-03-26 |