| NPI | 1740652791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OH APRN.CRNA.019468) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN CRNA 2049) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0992116-CRNA) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA-01517) | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2023-01-08 |