| NPI | 1427610583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 259569) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 259569) | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2022-11-03 |