| NPI | 1477691939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 8093-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 669610) |
| 163W00000X Registered Nurse (Licence: WI 129682) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4418) | |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2018-09-04 |