| NPI | 1427727221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 35456) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 147158) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2024-01-25 |