| NPI | 1477056281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 21973) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 217780) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 1477056281) | |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2023-04-20 |