| NPI | 1710419288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61145498) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 087669-23) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9236036) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 262591) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2022-05-31 |