| NPI | 1457908808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN.27185-APRN) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: CA 95107925) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95001704) | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-04-30 |