| NPI | 1851740146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2290811) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 077678-21) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA RN229081) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-02-25 |