| NPI | 1699383984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 6422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 290571) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 290571) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 891857) | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2022-11-07 |