| NPI | 1699383307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28137762A) |
| Additional Taxonomies | 163WF0300X Registered Nurse, Flight (Licence: IN 28137762A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0020158) | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2023-03-27 |