| NPI | 1285211318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN673456) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95242181) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001577) | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2023-11-06 |