| NPI | 1992349948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001238) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 829996) |
| Enumeration Date | 2019-11-02 |
| Last Update Date | 2020-08-19 |