| NPI | 1205995529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 084359-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: DC RN59997) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R115089) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024165528) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-12-30 |