| NPI | 1750966537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID 2861260) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: WA RN60786152) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-14 |
| Last Update Date | 2024-10-09 |