| NPI | 1144026378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WI 1822133) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 3317) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MN 2478521) | |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2026-03-29 |