| NPI | 1598279937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 256869) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN69357) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000524) | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2021-08-13 |