| NPI | 1922387174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 5394164-4406) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN76624) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000428) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0001232292) | |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2021-11-12 |