| NPI | 1689145427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 124913) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NV RN73141) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SD R047140) | |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2020-01-22 |