| NPI | 1033554183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: ID n-45970) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC RN.215484R) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2018-03-17 |