| NPI | 1891463436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.1000231-CRNA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704343331) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704343331) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2024-11-15 |