| NPI | 1346217049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NE NE100721) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 075096) |
| 163W00000X Registered Nurse (Licence: NE 57256) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IA D-075096) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-07-21 |