| NPI | 1750516100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA NA95000169) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 665319) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2018-10-08 |