| NPI | 1205474962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 082089-23) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CO 1624819) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2023-03-22 |