| NPI | 1033992144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PR 003690) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9632260) |
| 163W00000X Registered Nurse (Licence: PR 073619) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11027017) | |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |