| NPI | 1114371929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 36312) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NE 76008) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NE 101722) | |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2024-09-17 |