| NPI | 1578201174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 088292-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 206237) |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2023-12-14 |