| NPI | 1487959508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60510081) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO SRA100020) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2024-06-25 |