| NPI | 1346881588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 26595) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 1715680) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2021-07-27 |