| NPI | 1598185324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 6619885-4406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 806523) |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2018-08-28 |