| NPI | 1033815436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 864629) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV 145374) |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-03-10 |