| NPI | 1689700676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS 901620) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 170203) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 2206) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0001160419) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN apn0000011680) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA rn279123l) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-09-29 |