| NPI | 1396269338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000820) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 792212) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-07-16 |