| NPI | 1255930152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 837030) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NV RN90241) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-12-23 |