| NPI | 1891793212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11003616) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 5292991) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH RN290509) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA rn504261l) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 59827) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3824a) | |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2023-09-20 |