| NPI | 1659756138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024177947) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28179750A) |
| 163W00000X Registered Nurse (Licence: VA 0001287876) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 103831) | |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2019-08-22 |