| NPI | 1558073650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 95001943) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 95001943) |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2024-07-03 |