| NPI | 1285954438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 664221) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN71858) |
| 163WS0200X Registered Nurse, School (Licence: TX 664221) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000404) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2022-01-12 |