| NPI | 1134398589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1156094) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA 60787205) |
| 163W00000X Registered Nurse (Licence: NC 229032) | |
| 163W00000X Registered Nurse (Licence: AK 20620) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA 60787312) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60787312) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2024-11-01 |