| NPI | 1427881259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 37158) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 149978) |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-10-03 |