| NPI | 1215511407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 11026464) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9462851) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL 11026464) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 1129335) | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2025-01-15 |