| NPI | 1578032702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 079654-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11000902) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2341490) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ME RNA213023) | |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2023-02-22 |