| NPI | 1295131373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN95081554) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 5994) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CT 96553) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2022-01-06 |