| NPI | 1013550383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 246503) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001207) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 834330) | |
| Enumeration Date | 2019-10-19 |
| Last Update Date | 2021-10-15 |