| NPI | 1649349945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28277440A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 529270) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 074952) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024169078) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2023-11-22 |