| NPI | 1184138679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 247924) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA193051) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV RN80837) | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2021-01-14 |