| NPI | 1144269671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0029229) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK R2029229) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2026-04-03 |