| NPI | 1518539675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6907) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NC 242074) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 242074) | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2022-06-09 |