| NPI | 1598026205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-835A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-38631) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2018-03-17 |