| NPI | 1841844172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WY 44308) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 234139-30) |
| 163W00000X Registered Nurse (Licence: IN 28235362A) | |
| 163W00000X Registered Nurse (Licence: IL 041.452348) | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2021-09-27 |