| NPI | 1467713818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024175282) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0105716) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R208513) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2024-10-02 |