| NPI | 1477295681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95002069) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ RN179066) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2023-05-25 |