| NPI | 1881197325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP9422590) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 110910) |
| 163W00000X Registered Nurse (Licence: FL RN9422590) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 110910) | |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2022-08-14 |