| NPI | 1972671667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 082928-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9395768) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2014042320) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 102826) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-07-13 |