| NPI | 1275188179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: HI APRN-2729) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI RN-64335) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: HI 2729) | |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2023-12-11 |