| NPI | 1174194047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SA2100X Clinical Nurse Specialist, Acute Care (Licence: FL APRN11014055) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11014055) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2023-04-17 |