| NPI | 1225676000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 63244) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: UT 9273443-3102) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2020-01-17 |