| NPI | 1497272835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000772) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95000772) |
| Enumeration Date | 2017-08-26 |
| Last Update Date | 2018-10-16 |