| NPI | 1194832329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CO280CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CTP-000114) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0082272) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2018-03-22 |