| NPI | 1811214141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 2347) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 194547) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 84756) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2021-05-04 |