| NPI | 1033707252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MD R250567) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 248474) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NC 248474) | |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2022-01-07 |