| NPI | 1396383881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 130221) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28255655A) |
| Enumeration Date | 2019-12-15 |
| Last Update Date | 2020-02-05 |