| NPI | 1407338908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001209) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 836858) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 760909) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2024-04-18 |