| NPI | 1689016636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11041329) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-115992) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ APRN329135) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: DE L6-OA10844) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 791145) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA APRN10004453) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO C-APN.0104878-C-CRNA) | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2025-10-08 |