| NPI | 1891012894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN3186892) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61004444) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000173) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ANT 3186892) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2025-03-04 |