| NPI | 1992412613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11039855) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 1591095) |
| 163W00000X Registered Nurse (Licence: OH RN.507231) | |
| 163W00000X Registered Nurse (Licence: FL RN9687852) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OH 153326) | |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2025-08-04 |