| NPI | 1942870555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA GAA-CRNA002787) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP61442362) |
| Enumeration Date | 2021-06-26 |
| Last Update Date | 2024-10-23 |