| NPI | 1124618061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1087313) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO RN.1638551) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2023-07-19 |