| NPI | 1669891974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN593747) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN593747) |
| 163W00000X Registered Nurse (Licence: OH RN.312401) | |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9266653) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 101896) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2018-06-22 |