| NPI | 1366709743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 2676) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 253438) |
| 163W00000X Registered Nurse (Licence: SC 105563) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 089882) | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2023-04-18 |