| NPI | 1134795065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC APN.27457) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: SC 247324) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2024-03-18 |