| NPI | 1891018024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: VA 0024184265) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: FL 516784) |
| 163W00000X Registered Nurse (Licence: CA 650398) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 260373) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 3897) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9197186) | |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2022-09-01 |