| NPI | 1992874069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60065389) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-743) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MT NUR-APRN-LIC-101031) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AK NURA402) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-12-11 |