| NPI | 1316488422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704285098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 200965-6) |
| 163W00000X Registered Nurse (Licence: MI 4704285098) | |
| 163W00000X Registered Nurse (Licence: DC RN1033014) | |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2023-05-10 |