| NPI | 1093979643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NV CRNA000469) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ CRNA1014) |
| 163WF0300X Registered Nurse, Flight (Licence: AZ RN113754) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2025-01-02 |