| NPI | 1518744788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR 217727) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28209957A) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2026-03-18 |