| NPI | 1770850307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024172424) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: DC RN1010237) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: DC RN1010237) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD AC001344) | |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2021-07-29 |