| NPI | 1689048498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV 76078) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 109759) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2470285) | |
| 163W00000X Registered Nurse (Licence: PA RN654307) | |
| 163W00000X Registered Nurse (Licence: OH RN.419766) | |
| 163W00000X Registered Nurse (Licence: CO 1619598) | |
| 163W00000X Registered Nurse (Licence: NV RN74673) | |
| 163W00000X Registered Nurse (Licence: FL RN9423630) | |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2019-02-18 |