| NPI | 1770588543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AK 141) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 533) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: HI 755) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP30006355) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 1966) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 5191A) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GU NP0091) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2009-08-06 |