| NPI | 1568935344 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2024003579) | 
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024180934) | 
| 163W00000X Registered Nurse (Licence: FL RN9326546) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 12392129-4406) | |
| 163W00000X Registered Nurse (Licence: IN 28273162A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 264038) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11000747) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28273162A) | |
| Enumeration Date | 2019-01-04 | 
| Last Update Date | 2025-04-08 |