| NPI | 1396722344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9494266) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28164876A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041-287128) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2025-02-21 |