| NPI | 1720302870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA RN094700 AP06023) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: OK R0101839) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11013111) | |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2024-03-04 |