| NPI | 1942984000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.1001026-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 390200000X) |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2025-08-12 |