| NPI | 1841326782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200960010CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL rn3023222) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 3023222) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-07-17 |