| NPI | 1982318960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 090465-23) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 147028) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-04-25 |