| NPI | 1508223504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024176424) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 07430421) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ME RN64617) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 28202197A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA RN2298862) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC RN1039205) | |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2020-05-11 |