| NPI | 1801273321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-937A) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: ID N42090) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2016-12-09 |