| NPI | 1467626929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 1648) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 166919) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 079674) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2021-05-04 |