| NPI | 1851894463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003251) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 123622) |
| 163W00000X Registered Nurse (Licence: KS 140497) | |
| 163W00000X Registered Nurse (Licence: AR R091247) | |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2024-07-10 |