| NPI | 1548795271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024179484) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 117227) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX AP134368) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2022-08-12 |