| NPI | 1548528706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT 159520) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 201402871CRNA) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CO sra100081) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ND R51894) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-12-28 |