| NPI | 1861814238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9455337) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 675906) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA193038) | |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2024-08-09 |