| NPI | 1588923510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA4274) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 682809) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2021-11-30 |