| NPI | 1699450296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 338108) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 269443) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.0021268) | |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2026-08-17 |