| NPI | 1700143401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28248627A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SC 211588) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 843401) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2023-01-31 |