| NPI | 1912413444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 10005580) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL RN9521260) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NJ 26NJ00791500) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2568) | |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2023-10-11 |