| NPI | 1467978338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN23308) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: TN 201167) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2018-01-31 |