| NPI | 1598790966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT APRN-104594) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 370826-4406) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: ID RNA-583A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP60623618) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-12-12 |