| NPI | 1407277130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61034109) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28217946A) |
| 163W00000X Registered Nurse (Licence: NE 64532) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 10784997-4406) | |
| Enumeration Date | 2013-12-24 |
| Last Update Date | 2020-02-24 |