| NPI | 1437452596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1389) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2011004382) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN RN0000164694) | |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2020-10-12 |