| NPI | 1942594387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28212360A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28212360A) |
| 163W00000X Registered Nurse (Licence: IL 041392576) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209008884) | |
| 163W00000X Registered Nurse (Licence: TN 155454) | |
| 163W00000X Registered Nurse (Licence: KY 1144215) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 3009433) | |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2016-04-05 |