| NPI | 1760553317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 003602) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 76577) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 3681) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024174776) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2023-03-16 |