| NPI | 1932522984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 114554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R084170) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CTP-000259) | |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-09-26 |