| NPI | 1437420239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 17748) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 215793) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2022-01-27 |