| NPI | 1164829941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001157) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001214213) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024172256) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 653555) | |
| Enumeration Date | 2014-11-22 |
| Last Update Date | 2023-06-30 |