| NPI | 1437662483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28209273A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28209273A) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209022092) | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2022-05-01 |