| NPI | 1063082394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61524838) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN724252) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28274210A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: RN724252) | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2024-05-14 |