| NPI | 1467128306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 268565) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN177862) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2022-01-24 |