| NPI | 1265891295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NM CRNA 01415) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0996269-CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209021371) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 2355) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 10406-33) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61248892) | |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2022-05-11 |