| NPI | 1619137288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3906) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1390081012) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024168911) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 556930) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2011-10-18 |