| NPI | 1760469415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: DC RN1004845) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704221887) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R235618) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024182902) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2023-01-18 |