| NPI | 1821426081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL APRN9446750) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN APN0000031578) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MA RN2324800) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 18843) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 201365) | |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2022-05-27 |