| NPI | 1548911431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 848547) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2335003) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-08-03 |