| NPI | 1366582991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024179324) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R156137) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R156137) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-06-15 |