| NPI | 1467858233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C003096) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 107794) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2023-04-13 |