| NPI | 1972818763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000419) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NV RN57838) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: AZ RN160528) | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2024-08-27 |