| NPI | 1366468589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 10) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 303557) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 059417) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NV TCRNA800146) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-07-24 |