| NPI | 1902876097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000139) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN30581) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2017-11-09 |