Clinical Leadership
Dedicated. Talented. Focused.
Three words to sum up the team’s commitment
to unparalleled, long-term successful partnerships.
Rodney Pugh, MD
Chief Medical Officer
As MedStreams Chief Medical Officer, Dr. Pugh is responsible for the overall communication and engagement with the companys Medical Directors to provide leadership and oversight for new and prospective client facilities, as well as working proactively with our Chief Clinical Officer and Client Services team to develop strategies for our practice sites. He also supports the companys anesthesiologist recruiting efforts.
Thomas On, MD
Anesthesiologist & Managing Partner, Metro Anesthesia Consultants
Thomas On, MD, is an anesthesiologist and managing partner at Metro Anesthesia Consultants, a division of NPH. He is dedicated to delivering exceptional patient care and has played a key leadership role in the Success of the practice.
Robert Fabich, DNP, DHA, CRNA
Regional CRNA Director
Robert Fabich, DNP, DHA, CRNA, brings more than 25 years of healthcare experience spanning clinical practice, military medicine, and anesthesia leadership. As Regional CRNA Director for National Partners in Healthcare, he supports anesthesia operations, provider development, and collaboration with hospital leadership throughout the Northeast region.
John Dagirmanjian, MD
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Mark Ettinger, MD
President, Meridian Anesthesia
Dr. Mark Ettinger is a board-certified anesthesiologist with 20 years of clinical practice and physician leadership experience in Dallas–Fort Worth. He founded Meridian Anesthesia in 2025 and serves as its President, leading clinical operations, recruiting, and quality across Meridian’s hospitals, which include two trauma centers.
Valentine Gibson, MD
VP, Meridian Anesthesia
Dr. Valentine Gibson is a board-certified anesthesiologist with nearly two decades of clinical and healthcare leadership experience. He graduated Magna Cum Laude with a Bachelor of Science in Chemical Engineering before earning his Doctor of Medicine from the West Virginia University School of Medicine. He completed his anesthesiology residency at the University of Texas at Houston Medical School, where he served as Chief Resident and received the Outstanding Resident Award.
George Lavalliere
Chief Nurse Anesthetist at Amoskeag Anesthesia
George Lavalliere is a Certified Registered Nurse Anesthetist with over 30 years of clinical and leadership experience in anesthesia care. He currently serves as Chief Nurse Anesthetist at Amoskeag Anesthesia, a division of National Partners in Healthcare, in Manchester, New Hampshire. His role is serving as a mentor and resource person for the Amoskeag Anesthesia staff.