| NPI | 1861632721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 7420) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201360018CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9288164) | |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2024-09-16 |