| NPI | 1841493749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 13810) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002673) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AR CTP000040) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2023-12-02 |