| NPI | 1497324776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6702) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 317615) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 138463) | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-12-01 |