| NPI | 1942257415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA0423) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WY 48187) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 055992-23) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 683391) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 30199) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2025-08-14 |