| NPI | 1235665167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2316399) |
| 163W00000X Registered Nurse (Licence: CA 95235842) | |
| 163W00000X Registered Nurse (Licence: FL RN9331886) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2316399) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-12-17 |