| NPI | 1265856389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024190240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001190430) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 813161) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R251612) | |
| 163W00000X Registered Nurse (Licence: CA 813161) | |
| 163W00000X Registered Nurse (Licence: MD R251612) | |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2024-07-08 |