| NPI | 1447831003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 7325637-4406) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2018015155) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-06-27 |