| NPI | 1750950275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 1750950275) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MI 4704317005) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN11029309) | |
| Enumeration Date | 2021-06-19 |
| Last Update Date | 2024-09-27 |