| NPI | 1578172854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 083681-23) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 205913) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 132452) | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2023-01-23 |