| NPI | 1477528826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK 201464) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR R090656) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002907) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2021-04-15 |