| NPI | 1437211604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA3826) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: AZ RN108076) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2026-03-23 |