| NPI | 1902679160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 149768) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: IN 28243465A) |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2024-09-27 |