| NPI | 1891235271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 100017) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 77627) |
| 163W00000X Registered Nurse (Licence: OK 100017) | |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-05-26 |